NHS Direct has announced that it will not apply for foundation trust status “in the foreseeable future.” Its chief executive, Matt Tee, told E-Health Insider that it would instead pursue some of the freedoms offered to foundation trusts “without going through the Monitor process.”

A strategic health authority lead commissioning arrangement will also be put in place, so that NHS Direct’s services are commissioned by NHS East of England on behalf of the NHS, instead of by the Department of Health.

Tee said the decision not to pursue foundation status had been made following the final report of Lord Darzi’s Next Stage Review of the NHS and a short review of its operating and commissioning models conducted by KPMG.

He said the first had identified a need for more help and advice services for patients “which it might make sense to develop nationally rather than locally” while the second had identified its role in responding to major incidents and national events as being “of national importance.”

In a statement, NHS Direct said this had led to an agreement with the Department of Health that: “the traditional model of foundation trust may not be the most appropriate at the moment, given that one of the organisation’s strengths is its national operating model.”

Specialist tertiary centres, such as Moorfields Eye Hospital in London, have become foundation trusts. But Tee argued that they had a “geographical element” to their membership and referral patterns that NHS Direct did not have.

He said NHS Direct would seek to retain the approximately 16,000 members it recruited during a consultation on foundation status, because they represented important communities of interest. He also said the organisation would be looking to win new business.

“For example, could we support the Olympics?” he said. “Is there a role for us in London 2012, where we take a call in Wakefield about a health concern there?”

NHS Direct’s online presence is due to merge with NHS Choices so the NHS has a single major website, operating from the www.nhs.uk web address. However, Tee said the organisation was not looking to operate just as a telephone helpline.

He said it would be working closely with NHS Choices to develop a “multi-media” response service for patients. “For example, people might get to the end of the information on NHS Choices, and find a note asking whether they would like to speak to a nurse about their concern,” he said.

“They might fill in a form and have a nurse call them back. It should not matter whether people come in through the website or the phone, they should be able to switch from one to the other to get the help they need.”

The statement said the DH will work with NHS Direct on a package of freedoms to enhance its role.